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Fish Oil and Crohn’s Disease

The background for this study was that Crohn disease (CD) is associated with osteoporosis and other extraintestinal manifestations that might be mediated by cytokines from circulating (peripheral blood) mononuclear cells (PBMCs). Fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) reduces disease activity in patients with CD with raised laboratory markers of inflammation and in healthy subjects alters PBMC function.

The researchers objectives were to investigate the effect of fish oil plus antioxidants on cytokine production by PBMCs from patients with CD with raised C-reactive protein concentrations or erythrocyte sedimentation rates. They designed the study as follows: it was a randomized placebo-controlled trial of fish oil or placebo (olive oil); for 24 week was conducted in patients with CD. The fish-oil group additionally received an antioxidant preparation (vitamins A, C, and E and selenium).

Exclusion criteria included corticosteroid use. Fatty acid composition was measured by gas chromatography. Production of tumor necrosis factor a, interferon, and prostaglandin was measured by enzyme-linked immunosorbent assays after stimulation with mitogen and endotoxin (lipopolysaccharide). Fish-oil plus antioxidant dietary supplementation was associated with higher EPA and DHA incorporation into PBMCs and lower arachidonic acid and lower production of IFN-7 by mitogen-stimulated PBMCs and of PGE2 by lipopolysaccharide-stimulated PBMCs .

In conclusion dietary supplementation with fish oil plus antioxidants is associated with modified PBMC composition and lower production of PGE2 and IFN by circulating monocytes or macrophages. The response of extraintestinal manifestations of CD should be investigated in a randomized controlled trial.

The principal researcher of this study were Timothy M Trebble, Nigel K Arden, Stephen A Wootton, Philip C Calder, Mark A Mullee, David R Fine and Mike A Stroud. The conducted their research at The University of Southampton, Southampton, United Kingdom. The results were published in the Archives of Ophthalmology on July 1, 2006.

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